Medicare Part D: Which drug plan are you happy with?
6 years ago
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Medicare Part D Plan -- Big Increases
Comments (12)>>Aren't medical expenses in the US heavily concentrated on measures to stave off inevitable death? >> I've read several articles (must have been either AARP, NYTimes or WSJournal) that say that 80% of Medicare's budget is spent on 20% of insureds - the very frail and dying. But we should remember, this is true the world over. It's merely a question of who pays for it and for how long. Nobody anywhere wants to be the one who says to the family, "the plug has to be pulled because we're not going to pay for it any longer." Now, the ridiculous claim of "Medicare Death Panels" has been thoroughly debunked already, so no need to go over that ground again. Factually, ALL insurance companies globally have a Chief Medical Examiner whose job it is to approve or disallow payment for expensive treatments. That's what they do - balancing medical guidelines, doctor preferences, patient coverage, and company profit (no, company profit is not always paramount; but is an important factor in overall portfolio risk management). In the absence of clear, specific legal forms by the patient as to how end-of-life treatment is handled, the medical profession by its nature will do everything to save you from dying. Palliative care and pain management is only beginning to make an impact on their thinking, but again - without clear legal guidelines as to what the patient wants, ESPECIALLY if those instructions are contrary to what the family expresses - the doctors will do everything possible. And these days, "everything possible" is usually expensive with little regards to the quality of life. That's why it's absolutely critical to talk about what you want with not only your spouse, but your doctor and your family. Then put it in writing! BTW, I should amend my posting about the 'wellness' exam of the Healthcare Reform Bill. The NYTimes did an absolutely wonderful, comprehensive piece on this subject - what is covered, what is not, and why some consumers are surprised when they receive a bill they didn't expect. We have to remember, a physical exam for a 16-yr-old is going to be different than that of a 50-yr-old, which is again different than the exam for a 70-yr-old with severe medical issues. As it stands now, with the government gradually clarifying what is paid for and what is not, the two key things to note are: most of these don't begin until next year, and in areas where it's still 'gray' without legal definition, the insurers are allowed to make their own decisions about what is covered and what is not. (Access to the NYTimes is limited to 20 free articles/mo.) Preventing Sickness, With Plenty of Red Tape NY TImes September 19, 2011 (Excerpt) "Prevention has never been the cornerstone of American medicine. In this country, we tend to go to the doctor only when something is wrong, a habit long bemoaned by researchers and medical groups. The federal government aims to change that, and soon. Starting this year, insurers will be required under the Affordable Care Act to completely cover such services as annual physicals, childhood vaccinations and dozens of screening tests for everything from high blood pressure to abdominal aortic aneurysms. Just last month, the Department of Health and Human Services released additional guidelines specifying fully covered preventive services for women. Mammograms, cervical cancer screening and other services already had been mandated; the new recommendations expand that list to include screenings for human papillomavirus (which causes cervical cancer) and domestic abuse, and reimbursement and counseling for contraceptives. These services are to be fully covered by most insurance plans beginning in August 2012. Despite these new regulations, there's still a lot of ambiguity - and not just among consumers - about what qualifies as preventive care and what insurers are obligated to pay for. "I've seen so much confusion among patients and doctors alike trying to figure out what's paid for and what isn't," said Dr. John Santa, director of the Consumer Reports Health Ratings Center and a primary care doctor. " Here is a link that might be useful: Full Article: Preventing Sickness...See MoreChoosing 2011 Medicare Supplement + Part D Plans
Comments (10)You really might want to consider the former employer's pharmacy plan - but where I'm a bit confused... if your husband goes for the pharmacy plan for drug coverage and that proves satisfactory - why would there be a need for a switch to the Medicare Part D in 2012? He would, in effect, be dropping his creditable coverage and that creditable status doesn't carry over to a new plan (ie Medicare Part D because they don't care what you might have had), and would be subject to the forever penalty. Creditable is just comparing what you have against whatever else is out there. An actuarial firm determines that your plan offers Rx coverage that is equal to or better than Medicare Part D. Should be easy enough for him to get the boiler plate notice of "creditable" insurance for drugs from his former employer to keep in his files if he goes with what they're offering. In fact, it's a requirement that the notice be sent each year. It's an unimpressive few sheets of paper stating simply: The Society (I'm retired from the Nat'l Geographic Society) is required to issue this annual notice to participants. Then it goes on to explain Medicare Part D, why I don't need it, why I can't be covered for drugs under more than one plan, and what happens if I drop what I have for something else. I still think that the Medicare Part D penalty is imposed whenever it is not signed up for when you initially become Medicare eligible at 65. Guess I would check with the former employer - HR there should be on top of what they offer. And I'd call Medicare too - or your closest SS office. I found the people at our Social Security office really helpful - on the phone and in person....See MoreWhich supplemental Medicare plan do you have?
Comments (29)Just thought I would report back that I looked into Bankers Fidelity and for me it is $205 a month for Plan F and $141 for Plan G. Plan F is an "issue age plan" and G is an "obtained age plan". I called the company and a very annoying local insurance agent called me back. Actually she seemed to know her stuff but her manner was annoying. I think AARP is going to be hard to beat. I downloaded and printed a booklet called Choosing a Medigap Policy and it is very helpful. It makes things clear and has great advice about what to ask an insurance agent if you choose to buy from one. It's on the medicare.gov site. Maybe my research will help the next person and it certainly helps me to bounce these questions off all of you!...See MoreAbout Medicare Part D prescription drug plans....
Comments (11)alisande -- If I were you, I'd go with the cheapest premium. Yes, you *could* pay that $320 deductible -- IF you are prescribed enough meds to reach that limit. (Even if you did, it's still less than your current Part D will be in 2015.) That Humana/Wal-Mart plan is offered here, too. DH and I will each breeze right through that deductible with our outrageously priced meds, regardless, so it may make sense for us too. Our 2014 WellCare Part D is going up from $20/mo. to $30/mo. I don't see keeping that if we can do better. Have you 'run the numbers' on Part D plans on www.medicare.gov Re:Deductibles. In 2012 and 2013 we had a Medicare Supplemental Plan F that paid for everything and the kitchen sink. For 2014 we took a Plan F- High Deductible ($2200/pp deductible) and are money ahead. We could afford to pay that $2200 each if necessary, but I have only had about $300 in out of pocket and DH less. We were still protected in the event of HUGE medical bills. Re: Filling prescriptions. We are fine with 90-day supplies from mail order on our maintenance meds. This year my cost for Advair was a third lower via mail order. (It's still a big rip-off, but that's because the US doesn't negotiate pricing with the pharmaceutical companies.)...See More- 6 years ago
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